Heading into the 2026 midterms, health care affordability has become the defining economic concern for voters across party lines — creating pressure that is actively reshaping what is politically viable in Washington and what is not. This session offers a candid, grounded assessment of what the second Trump administration's health policy agenda means for integrated, team-based care: tracing the first-year record from the One Big Beautiful Bill Act's Medicaid restructuring and the expiration of ACA enhanced subsidies, to the consolidation of SAMHSA and HRSA into the new Administration for a Healthy America, to the rollout of the MAHA agenda and its emphasis on chronic disease prevention and whole-person care. The picture is not one-dimensional — federal coverage losses and behavioral health funding pressures pose serious near-term challenges, while the administration's investment in models like MAHA ELEVATE and its philosophical focus on root-cause, lifestyle-based approaches reflect genuine, if imperfect, alignment with integrated care's core premises. Attendees will leave with a clear-eyed view of the threats, a realistic map of the opportunities, and practical strategies for advancing integrated care at the state level and through payment reform — regardless of who controls Washington.